Nutritional status of disabled schoolchildren in Bloemfontein (2002-2003)
Objectives. To assess the nutritional status of disabled schoolchildren using anthropometric measures and
dietary intake, and to compare estimated energy expenditure with energy intake and body weight.
Design. A descriptive, cross-sectional survey was undertaken.
Setting. The study was conducted at three Bloemfontein schools for disabled children (Tswellang: physically
disabled, Pholoho: mentally disabled, Martie du Plessis: both mentally and physically disabled).
Subjects. Subjects included a random selection of 145 boys and girls aged 8 - 15 years.
Outcome measures. Standard methods were used to determine height, demi-span, knee-height, weight, midupper
arm circumference and triceps skinfolds. A 24-hour recall combined with a food frequency questionnaire
and 7-day weighed food record were used to determine usual dietary intake of day scholars and hostel scholars
respectively. Resting energy expenditure (REE) was calculated for each child using Shöfield equations. Total
energy expenditure (TEE) was calculated by multiplying the appropriate physical activity level (PAL) factor by
Results. The high prevalence of stunting (weight-for-height < –2 standard deviations (SD)) (Tswellang 47.7%,
Pholoho 37.3%), and underweight (weight-for-age < –2 SD) (Tswellang 29.8%, Pholoho 18.7%) was a matter of
concern. Although median energy intake was slightly lower than the recommended intakes, median protein
intake tended to be adequate, while micronutrient intake was low. Median energy intake determined by the 24-
hour recall tended to be lower (Pholoho –769 kJ) or nearly the same (Tswellang 327 kJ) as the calculated TEE (PAL
1.2 - 1.8).
Conclusion. Nutrient density and texture of the children's diet should be monitored to improve nutritional
status. In future studies more accurate methods should be used to determine energy intake and expenditure
South African Journal of Clinical Nutrition Vol. 20 (1) 2007: pp. 6-15